Sunday, November 25, 2012

ADHD, Criminal Behavior, and Homework

A recent study
was cited that shows that late teens and adults with ADHD who continue
treatment with psychostimulant medications are less likely to commit crimes
than those who do not continue those medications.

It is clear to
me as a practicing clinical psychologist, that (despite an obvious
over diagnosis of ADHD) there are people with this condition who cannot function,
when young, in normal classroom environments. They need medication and,
according to this study, they need to continue as adults and late teens. So let’s
ask a different question, “Under what conditions will a person with ADHD be
willing to continue medications?” After all, the point of this study is moot if
the person won’t take the meds.

I have seen large
numbers of people who were treated for ADHD as kids, resent their treatment, and
refuse to continue once they are old enough to make their own decisions. They often
gravitate to illegal, attention-enhancing drugs, but they won’t take prescribed
medications. So we need to understand what goes on in the mind of the child to
pave the way to distrust adults when they grow up.

I’ll start with homework.
The typical child with ADHD takes medication to manage what is otherwise a
difficult school day. He’s successful there, but then goes home to more work
and more medication, having less time to run around and play. The medication
interferes with appetite and sleep, and his daily experience is of being pressured
by his parents to keep working without relief. He resents what is happening and
this sows the seeds for refusing medication later on.

If we believe
that children who stop their medication in their late teens and early adult
years are placing themselves at risk, and that risk includes criminal
consequences (something I see often in my clinical practice), then let’s begin
by considering not only what works, but what will cause those children to
believe in the interventions we use.

I was born with congenital
heart problems. I have had surgery twice, once as a child, once as an adult,
and have had to see cardiologists all of my life. As a youth, I may have
resented the condition I had, but I never questioned my need to see doctors and
take care of my health.I was given
protection and relief, including the opportunity to rest after school. I was
not pressured to do things I could not do.

Children with
ADHD have a different experience. They feel controlled and they feel pressured,
and that’s a dangerous combination when we think about their future. Now, we’re
being told that this increases the chance that they might go to jail. Let’s
medicate them during the day. Let’s let them off the hook when they come home.